Ask An Expert: Constipation in a Child

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Ask An Expert: Constipation in a Child

Question:

How common is it to treat constipation in a child with Miralax — for more than three years? Are there other treatments? Can it be controlled by diet?

Answer:

I have certainly seen constipation in children treated with Miralax for extended periods of time, even years. Usually these children have chronic constipation, the kind that lasts for a long time, is difficult to treat, and comes back quickly if untreated.

Miralax is one of the more gentle agents to treat chronic constipation. It works by drawing water into the intestine, which helps stool stay soft and pass through the intestine more quickly. Miralax has few side effects. It isn't absorbed into the bloodstream. It is tasteless and mixes easily with juice or milk, so children will usually not protest about taking it compared to many other medications.

Whenever a medication is used for such a long time, it should be done under careful medical supervision. In this case, if the child hasn't seen a gastroenterologist, the kind of doctor that specializes in problems of the digestive system, it might be a good idea to do so. On rare occasions chronic constipation can be a sign of a more serious problem, such as hypothyroidism, cystic fibrosis, or Hirshsprung's disease.

Improving the diet can make a big difference in treating constipation. A high-fiber diet is best, with lots of fruits, vegetables, and whole grains. Bran cereals can help, and prunes or prune juice are natural laxatives. Drinking plenty of water and other fluids is important, too.

Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".

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Last updated:	January 24, 2007

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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